A lump in breast tissue is very common and fortunately often benign. However, as cancer breast lumps are not infrequent, each lump must be taken serious and investigated until the physician is satisfied that a malignancy has been ruled out. In an investigation of a number of women with a breast lump the following breakdown of underlying diagnoses was found (modified from Ref. 8, p. 1096).
Reasons for common breast lumps
| Pathological condition: | Occurrence: | Comments: |
| Fibrocystic disease | 40 % | painful and in both breasts |
| No disease found | 30 % | hormone dependent reversible fluid retention may account for some of these |
| several benign changes | 13 % | polyps, cysts, benign papillomas etc. |
| breast cancer | 10 % | mostly on one side, feels hard |
| fibroadenoma | 7 % | often on one side, feels rubbery |
There is a protocol that the physician follows when a woman comes into the office and complains about a lump. The physician will take a history and then examine. If there is a hard lump in the breast, there is more of a probability that it might be a cancerous lump versus a rubbery or soft breast lump that would more likely be a benign breast lump. An ultrasonic examination will distinguish between a cystic lesion and a solid lesion. A cystic lesion is common and is mostly benign. A solid lesion would likely need a fine needle biopsy or if this is technically difficult, would have to be surgically removed (called “lumpectomy”). Histological examination of the biopsy material from the breast lumpectomy is decisive.
As can be seen from the table above, only about 10% of all clinical lumps (highlighted in table) turn out to be cancerous, but the physician and the patient cannot afford to overlook this. Regular breast self examination and mammographies are important to find a breast lump as part of breast cancer detection. It might be that overall too many lumps are removed unnecessarily, but it is safer to err on the cautious side than to miss breast cancer.
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